World journal of emergency medicine · 2025
The role of early changes in routine coagulation tests in predicting the occurrence and prognosis of sepsis.
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Chen Peili, Ge Yan, Sheng Huiqiu, Sun Wenwu, Wang Jiahui, Ma Li, Mao Enqiang
Аннотация
BACKGROUND: This study aimed to explore the importance of routine coagulation tests for the early detection of sepsis and to quickly identify patients at a high risk of mortality.
METHODS: This retrospective single-center study collected data from patients meeting the clinical criteria for systemic inflammatory response syndrome (SIRS) with a confirmed infection source. Patients with coagulation disorders or on medications affecting coagulation were excluded. Patients were divided into sepsis and non-sepsis groups based on a Sequential Organ Failure Assessment (SOFA) score of ≥2. Univariate and multivariate logistic regression identified indicators from routine coagulation tests that predict sepsis. Prognostic roles of coagulation indicators were analyzed within the sepsis group.
RESULTS: A total of 512 patients were included, with 396 in the sepsis group and 116 in the non-sepsis group. The predictive factors in the sepsis prediction model encompass fibrin degradation products (FDP), D-dimer, lactate, procalcitonin (PCT) levels and the utilization of mechanical ventilation. Early elevation of FDP and D-dimer levels predicted sepsis onset. The model exhibited an area under the curve (AUC) of 0.943 (95% CI: 0.923-0.963). In the sepsis group, Cox regression analysis revealed an association between prothrombin time (PT) and in-hospital mortality.
CONCLUSION: Abnormal high FDP and D-dimer levels in the early stages of sepsis provide a supplementary method for predicting sepsis. As the disease progresses, prolonged PT in the early stages of sepsis suggests a poor prognosis.
METHODS: This retrospective single-center study collected data from patients meeting the clinical criteria for systemic inflammatory response syndrome (SIRS) with a confirmed infection source. Patients with coagulation disorders or on medications affecting coagulation were excluded. Patients were divided into sepsis and non-sepsis groups based on a Sequential Organ Failure Assessment (SOFA) score of ≥2. Univariate and multivariate logistic regression identified indicators from routine coagulation tests that predict sepsis. Prognostic roles of coagulation indicators were analyzed within the sepsis group.
RESULTS: A total of 512 patients were included, with 396 in the sepsis group and 116 in the non-sepsis group. The predictive factors in the sepsis prediction model encompass fibrin degradation products (FDP), D-dimer, lactate, procalcitonin (PCT) levels and the utilization of mechanical ventilation. Early elevation of FDP and D-dimer levels predicted sepsis onset. The model exhibited an area under the curve (AUC) of 0.943 (95% CI: 0.923-0.963). In the sepsis group, Cox regression analysis revealed an association between prothrombin time (PT) and in-hospital mortality.
CONCLUSION: Abnormal high FDP and D-dimer levels in the early stages of sepsis provide a supplementary method for predicting sepsis. As the disease progresses, prolonged PT in the early stages of sepsis suggests a poor prognosis.